What to Expect at Your First Botox Treatment

Botox is famous as the anti-aging treatment first embraced by celebrities, and also notorious for causing the face to appear smooth and immobile. But in the 15 years since it was first approved for cosmetic use, techniques and dosages have been refined and perfected, so that now people can use Botox to appear fresher and more youthful, without sacrificing their natural look.

Botox is a neurotoxin that works by blocking the nerve signals between the muscles and the brain. In cosmetic applications, it prevents muscle contractions in the face. It is these repeated contractions from habitual expressions that cause deep creases to form in the skin. Forcing those muscles to relax (not “freeze”, as is often suggested), prevents the habitual tugging at the skin that causes age-related creases and wrinkles. When administered properly, Botox smooths the muscles which, in turn, smooth the skin.

If you've never had Botox injections, here's what you can expect and plan for during your first session:

Is Botox for you?

Botox is not suitable for women who are pregnant or breastfeeding, or for people who are allergic to eggs or egg products. You may need to wait until another time, or search for a non-Botox injectable.

Planning your session:

• The results will always depend on the skill and expertise of your provider. It's important to take your time and make the right decision. A good provider will have:
  • Specialized training. Make sure they are a trained professional with specific experience in Botox and cosmetic injectables.
  • Good reviews. Check online reviews to verify that other people have had positive experiences.
  • Appropriate pricing. As with many other things, you get what you pay for. Beware of very low prices or steep discounts. It's your face, and not a process where you want to compromise quality to save money.
• Schedule a consult. If possible, schedule a consultation with your provider. Verify that the facilities are clean and safe, and that your provider listens to your goals and concerns and makes you feel comfortable.
• Plan for your aftercare. When scheduling your appointment, remember that Botox treatments are most visibly effective 1-2 weeks after the session. If you are planning for an important event, like a wedding or reunion, schedule accordingly. 

Before your treatment:

• Avoid anti-inflammatory drugs and medications for 1 week before your session. This includes:
• Ibuprofen
• Motrin
• Advil
• Aleve
• Vioxx
• aspirin
• Vitamin E
• Ginko Biloba
• Avoid alcohol for 24 hours before your session. It may increase the chances of bruising or swelling.

During the procedure:

• Botox injections should not be painful, but there will probably be a mild stinging sensation.
• Botox injections for excess sweating in the underarm area are more painful than injections in the face, and a provider may use a topical anesthetic.
• Communicate your comfort level during the treatment.

Immediately after the session:

• Some people experience minor redness, swelling, or bruising at injection site. Some people also experience a mild headache. These usually resolve naturally within hours.
• Do not lie down for 2-4 hours afterward, and avoid pressing or manipulating the treated area. Pressure and touching may accidentally move the Botox away from the treated area into areas not meant to receive it.
• Do facial exercises for an hour afterward. Squinting, frowning, smiling, and other habitual expressions ensure that those muscles remain mobile and responsive.

In the days and weeks after Botox:

• Results typically take a day or two to be visible, and have their peak impact within 1-2 weeks after the session.
• Botox will wear off gradually over the next 3-4 months

Botox over time:

• Long-term, consistent use of Botox prolongs the effectiveness of the treatment. As these muscles are relaxed over time, they lose the habitual contractions that form the visible creases and wrinkles, so the treatments can be spaced over longer periods of time with the same results. 

If you haven't ever had Botox, these steps will help you know what to expect and how to get the greatest benefit from your treatment. But remember that it's always important to consult with a licensed and trained provider; it's possible that, with your individual skin, and your goals and concerns, they may recommend a different course of treatment. If you've chosen a good provider, it's a smart idea to trust their judgment.

If you've previously had Botox and weren't happy with the results, it may be that you were simply with the wrong provider. It's worthwhile to consult with a better provider and see if it can be addressed, or if it's better to wait for it to wear off and try again.